Sayers Steven L, White Tracela, Zubritsky Cynthia, Oslin David W
VISN 4 Mental Illness, Research, Education, and Clinical Center and the Philadelphia Veterans Affairs Medical Center, PA 19104, USA.
Fam Pract. 2006 Jun;23(3):317-24. doi: 10.1093/fampra/cmi114. Epub 2006 Feb 3.
Although the involvement of patients' family members in office visits has been examined extensively, less is known about the involvement of family members in supporting patients' medical care outside of office visits.
This study examines two questions: What types of family involvement do family members have in the medical care of relatively healthy older outpatients, and does self-rated health moderate patients' reactions to this family involvement?
Patients from a large sample of medical practice outpatients (N = 1572) were assessed to determine perceived emotional support, involvement of family members in their medical care, as well as the presence of depressive symptoms.
Approximately 50% of patients had some family involvement in their medical care (e.g. taking part in medical decisions, reminding the patient to take medication). Marital status was a stronger predictor of family involvement than self-ratings of poor physical health. Additionally, there was no evidence that older patients who report good health have less favourable reactions to family involvement in their medical care.
Family involvement in medical care occurs routinely and is most likely to involve a spouse, and is consistent with family interaction patterns among older adults. These findings also suggest that when providers invite family members to support treatment outside the office visit, these invitations are appropriate for older adult patients across a continuum of good to poor health.
尽管患者家庭成员参与门诊就诊已得到广泛研究,但对于家庭成员在门诊就诊之外支持患者医疗护理方面的参与情况,我们了解得较少。
本研究探讨两个问题:家庭成员在相对健康的老年门诊患者医疗护理中参与哪些类型的事务,以及自我评定的健康状况是否会缓和患者对这种家庭参与的反应?
对来自大量门诊患者样本(N = 1572)的患者进行评估,以确定其感知到的情感支持、家庭成员在其医疗护理中的参与情况以及抑郁症状的存在情况。
约50%的患者在医疗护理方面有一定的家庭参与(例如参与医疗决策、提醒患者服药)。婚姻状况比自我评定的身体不健康状况更能预测家庭参与情况。此外,没有证据表明自我报告健康状况良好的老年患者对家庭参与其医疗护理的反应更不利。
家庭参与医疗护理是常规现象,最有可能涉及配偶,这与老年人的家庭互动模式一致。这些发现还表明,当医疗服务提供者邀请家庭成员在门诊就诊之外支持治疗时,这些邀请适用于健康状况从良好到较差的老年患者。